Date: 19 August 1955
Cert: # 23131
Place of Death: County: Knott City or Town:
Sassafras, Rural
Length of stay (in this place): (blank)
Street address or location: home
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Bulan - Rural Street Address: (blank)
Full Name: Susan MESSER
Date of Death: 19 August 1955
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 24 December 1880
Age: 74 years
Usual Occupation: Housewife
Kind of Industry or business: (blank)
Birthplace: Knott Co., Ky.
Father's Name: Alex FUGATE
Mother's Maiden Name: Julia CAMPBELL
Was deceased ever in armed forces: No
Social Security No.: (blank)
Informant: Irvin MESSER
Disease/condition directly leading to death: Cancer of
sigmoid C
Interval between onset and death: 01 year
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from May 1955 to
August 1955, that I last saw the deceased alive on 12 August
1955, and
that death occurred at 3 a.m., from the causes and on the
date stated above.
Date signed: 23 September 1955
Address: Hazard, Ky.
Signature: (illegible) M.D.
Burial, Cremation or Removal: Buried
Date: 21 August 1955
Name of Cemetery or Crematory: Holiday Cemetery
Location: Ary, Ky.
Date received by local registrar: (illegible)
Registrar's Signature: Myrtle Slone
Funeral director & address: Engle Funeral Home,
Hazard, Ky., (illegible) Compton
Transcribed by Debbie Tamborski, 10 June 2011 |